CAGAYAN STATE UNIVERSITY COLLEGE OF NATURAL SCIENCES AND MATHEMATICS

SURVEY ON RABIES PREVENTION AND CONTROL

A Research Paper

Presented to the Faculty of the

College of Natural Sciences and Mathematics

Cagayan State University, Carig Campus

Tuguegarao City, Cagayan

In Partial Fulfillment of the

Academic Requirements for the Subject

General Zoology

S.Y 2023-2024

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CAGAYAN STATE UNIVERSITY COLLEGE OF NATURAL SCIENCES AND MATHEMATICS

ABSTRACT

Rabies is a severe zoonotic disease with a 100% case fatality rate in animals and humans.
The disease is caused by Lyssavirus, which is transmitted through the saliva of an infected
animal. The ASEAN Rabies Elimination Strategy states that rabies causes 59,000 deaths every
year worldwide, with 56% of the cases occurring in Asia. The Philippines ranks with the
highest rabies incidence in the world, claiming 250–300 lives annually, mainly due to dogs
being the main reservoir of transmission. Although rabies is preventable, rabies cases
remained high due to several factors, including limited access to quality pharmaceuticals,
including vaccines and immunoglobulin, a lack of access to public health and veterinary
services, and a general lack of knowledge about the disease and the significance of getting
treatment after dog bites.

To monitor rabies cases and deaths, surveillance systems are implemented at both the
national and global levels. Monitoring rabies cases, deaths, and the case fatality rate is
essential for understanding the burden of the disease and evaluating the effectiveness of
control measures.

Therefore, this research study aims to ascertain the quantity of dog bite cases, deaths, and
case fatality rate that occurred in the previous and recent years. Further, this study also
seeks to determine the factors that contribute to the incidence of rabies cases and deaths.
By continuously monitoring and adapting strategies, we can work towards reducing the
incidence of rabies and preventing unnecessary deaths.

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TABLE OF CONTENTS

Page

Title……………………………………………………………………………………………………………………... i

Abstract………………………………………………………………………………………………………………. ii

Table of Contents…………………………………………………………………………………………….…… iii

CHAPTER I: THE PROBLEM AND ITS BACKGROUND……………………………………………… 1

Introduction……………………………………………………………………………………………… 1

Objectives………………………………………………………………………………………............ 3

CHAPTER II: MAIN DISCUSSION……………………………………………………………………………. 4

2.1. Surveillance of Rabies case, deaths and the case fatality rate……….… 4

2.1.1. Data on incidence of Rabies Cases, Death and the …….... 5

Case Fatality Rate (CFR) Reported in 2022-2023 by Region,
Philippines
2.2 Factors contribute to rabies cases and deaths………………………………….… 6

2.2.1. Limited access to quality pharmaceuticals, ...………………..... 6

including vaccines and immunoglobulin

2.2.2. Lack of access to Public Health and Veterinary Services………… 7

2.2.3. Lack of education and awareness concerning rabies……………. 8

CHAPTER III: CONCLUSION………………………………………………………………………………...... 10

REFERENCES…………………………………………………………………………………………………………. 11

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CAGAYAN STATE UNIVERSITY COLLEGE OF NATURAL SCIENCES AND MATHEMATICS
CHAPTER I
THE PROBLEM AND ITS BACKGROUND
INTRODUCTION
Rabies is a global problem that poses a threat to humans. It is a zoonotic disease that
remains one of the most serious and distressing diseases, with a 100% case fatality rate in
animals and humans. Rabies is caused by infection with the Lyssavirus of the Rhabdoviridae
family, which is transmitted via the saliva of an infected animal.

According to the ASEAN Rabies Elimination Strategy, rabies causes 59,000 deaths every year
worldwide, with 56% of the cases occurring in Asia. In the Philippines, it is one of the most
difficult diseases to treat, claiming 250–300 lives every year, nearly half of whom are
children. Although rabies is preventable, rabies cases remained high due to several factors,
including limited access to quality pharmaceuticals, including vaccines and immunoglobulin,
a lack of access to public health and veterinary services, and a general lack of knowledge
about the disease and the significance of getting treatment after dog bites. As a
consequence, human rabies incidence has remained stable in most rabies-endemic areas of
the country.

Dogs are the main reservoir of rabies transmission. According to the ASEAN Rabies
Elimination Strategy, dog rabies is endemic in most of Southeast Asia, where about 608
million people are at potential risk. The World Health Organization (WHO) states that dogs
are responsible for 99% of cases of human rabies, primarily through dog bites, while the
remaining 1% is attributed to cats and other domestic animals. Cats, cattle, buffaloes,
horses, pigs, and other domestic and wild animals are also rabies-susceptible and have been
reported in the region. However, dogs are considered to be the most important
maintenance host and transmitter of rabies to humans.

Despite the fact that rabies is preventable, rabies cases remained high due to several factors,
including limited access to quality pharmaceuticals like vaccines and immunoglobulin. As a
severe consequence, the Philippines ranks with the highest rabies incidence in the world. In
some instances, it still remains a neglected disease in most regions of the Philippines due to
a lack of access to public health and veterinary services that are responsible for addressing

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CAGAYAN STATE UNIVERSITY COLLEGE OF NATURAL SCIENCES AND MATHEMATICS
rabies effectively to ensure a comprehensive and integrated approach to rabies prevention
and control. As a consequence, the poorest members of the population are most at risk of
exposure and death from rabies, and this segment of society is often overlooked.

In order to take the country off the list of the top rabies-affected nations worldwide, the
national government enacted Republic Act 9482, also known as the Anti-Rabies Act of 2007.
According to the Strategic Plan 2020–2025, this law led to the creation of the National Anti-
Rabies Committee and the National Anti-Rabies Program, the framework that promotes
cooperation among government agencies, non-government organizations (NGOs), and
people’s organizations (POs) for the prevention and control of rabies in the country. The
program will be a multiagency effort to control and eliminate rabies in the country. Among
the component activities are: (1) mass vaccination of dogs; (2) establishment of a central
database system for registered and vaccinated dogs; (3) impounding field control and
disposition of unregistered, stray, and unvaccinated dogs; (4) conduct of an information and
education campaign on the prevention and control of rabies; (5) provision of pre-exposure
treatment to high-risk personnel and post-exposure treatment to animal bite victims; (6)
provision of free routine immunization or pre-exposure prophylaxis (PrEP) of schoolchildren
aged five to fourteen in areas where there is a high incidence of rabies; and (7)
encouragement of the practice of responsible pet ownership.

Despite a national law aimed at controlling and eradicating rabies, the number of cases of
the disease is continuing to rise. Due to this fact, the level of knowledge and awareness that
are necessary to understand how to prevent these rabies diseases is low. The World Health
Organization (WHO) claims that the Philippines has one of the highest rates of rabies cases
in the world. This is largely due to a lack of understanding about the disease and how it can
be prevented. Without proper education, individuals may not know the importance of
vaccinating their animals or seeking medical attention after being bitten by an animal.
Another consequence of the lack of education and awareness about rabies is the economic
burden it places on the healthcare system. Treating rabies can be costly, especially when
individuals delay seeking medical attention. Additionally, the government has to allocate
resources for post-exposure prophylaxis, which includes administering vaccines and
immunoglobulin to individuals who have been bitten by a rabid animal.

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CAGAYAN STATE UNIVERSITY COLLEGE OF NATURAL SCIENCES AND MATHEMATICS
By implementing comprehensive education and awareness programs, strengthening the
capacities of public health and veterinary services, and providing sufficient access to quality
pharmaceuticals, including vaccines and immunoglobulin, we can address this issue and
reduce the incidence of rabies in the country.

Therefore, this research study aims to ascertain the quantity of dog bite cases, deaths, and
case fatality rate that occurred in the previous and recent years. Further, this study also
seeks to determine the factors that contribute to the incidence of rabies cases and deaths.
By continuously monitoring and adapting strategies, we can work towards reducing the
incidence of rabies and preventing unnecessary deaths.

OBJECTIVES

The research study attempts to ascertain the total quantity of rabies cases, deaths, and the
calculation of the case fatality rate (CFR). As well, the incidence of rabies has remained high
due to several factors contributing to this ongoing issue.

Specifically, the study seeks to accomplish the following:

1. To ascertain the quantity of dog bite cases and deaths that occurred in the previous
and recent years.
2. To determine the incident or case fatality rate in each region of the Philippines.
3. To determine the factors that contribute to rabies cases and deaths.

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CHAPTER II
MAIN DISCUSSION
The main discussion is organized into two themes related to rabies and the data on
incidence in rabies cases.

2.1 Surveillance of Rabies case, deaths and the case fatality rate

Rabies is a viral disease that affects both animals and humans and is transmitted through the
bite of an infected animal. According to the World Health Organization (WHO), rabies is a
significant public health concern worldwide, with an estimated 59,000 human deaths
occurring annually. The Philippines is among the top 10 countries worldwide with the
highest number of human rabies deaths, with approximately 200–250 cases reported each
year.

Through Surveillance we can ascertain the total quantity of rabies cases, deaths, and the
calculation of the Case Fatality Rate (CFR). According to Global Alliance for Rabies Control,
Rabies surveillance involves monitoring and tracking cases of rabies, including both animal
and human cases. It is the systematic collection, analysis, and interpretation of data related
to rabies cases. By recording and analyzing the number of cases and deaths attributed to
rabies, health authorities can assess the impact of the disease and evaluate the effectiveness
of prevention and control strategies.

On the other hand, the case fatality rate (CFR) is a measure of the proportion of individuals
diagnosed with a particular disease who die from it. In the case of rabies, calculating the CFR
requires accurate data on the number of confirmed rabies cases and the number of deaths
attributable to the disease. The surveillance of CFR provides insights into the severity and
impact of rabies on human health.

Surveillance of rabies cases, death, and CFR relies on various sources of data. These include
reports from healthcare providers, veterinary clinics, and laboratories. Collaboration
between human and animal health sectors is essential for comprehensive surveillance, as
rabies affects both humans and animals. Timely reporting of cases and deaths is crucial for
effective surveillance and response.

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Data collected through surveillance can inform public health policies and interventions. It
helps identify areas where vaccination campaigns should be prioritized, control measures
should be strengthened, and public awareness should be increased. By monitoring trends
over time, health authorities can evaluate the impact of prevention and control efforts and
make informed decisions to mitigate the spread of rabies.

Surveillance of rabies cases, deaths, and CFR is vital for understanding the prevalence,
impact, and distribution of the disease. It provides valuable insights into the effectiveness of
prevention and control strategies and guides public health interventions. Through
collaborative efforts and timely reporting, we can work towards reducing the burden of
rabies and protecting both animal and human populations.

2.1.1 Data on incidence of Rabies Cases, Death and the Case Fatality Rate (CFR) Reported
in 2022-2023 by Region, Philippines

Rabies is still a fatal, but neglected, disease (Amoaka et al., 2021). The incidence of rabies
remains high in the Philippines. Due to several factors that contribute to the spread of the
disease, such as lack of awareness and access to vaccines, the number of cases continues to
rise.

In 2022, we had the highest total number of cases and deaths, with a total of 254 and an
incidence rate of 0.23. Region 3 obtained the highest total number of cases and deaths

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within the country, with a total of 35, while the CAR had no reported incidents of rabies. On
the other hand, in 2023, the total number will descend to 230 with a case fatality rate of
0.21. CALABARZON gained the most cases with a total number of 39, and BARMM obtained
the lowest with a total of 1.

Rabies disease continues to pose a significant threat to public health and requires urgent
attention and intervention. It is crucial to implement effective prevention and control
measures to reduce the number of cases and prevent the further spread of the disease.

2.2 Factors contribute to rabies cases and deaths.

Rabies is a deadly zoonotic disease primarily transmitted through the bite of an incidence of
rabies has remained high due to several factors contributing to this ongoing issue.

The following are the factors that contribute the most to the incidence of rabies cases and
deaths:

1. Limited access to quality pharmaceuticals, including vaccines and immunoglobulin

2. Lack of access to Public Health and Veterinary Services
3. Lack of education and awareness concerning rabies.

2.2.1 Limited access to quality pharmaceuticals, including vaccines and immunoglobulin

Access to quality pharmaceuticals, including vaccines and immunoglobulin against rabies, is

essential for preventing and managing rabies cases. Vaccination is a highly effective measure
for preventing this deadly disease in both humans and animals. According to the ASEAN
Rabies Elimination Strategy, the quality of vaccines and immunoglobulin is critical to the
success of any rabies elimination plan. The World Health Organization (WHO) clearly states
those pharmaceuticals that provide safe and effective pre- and post-exposure prophylaxis.
Additionally, the WHO outlines the categories of biological products available for passive
immunization. However, there is a global shortage of rabies immunoglobulins, which
signifies that the Philippines will not be supplied with enough of the vaccine to eradicate
this fatal illness.

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In addition, the Philippines has to have a mechanism, a plan, and a strategy to access high-
quality vaccinations against rabies and testing for diagnostic purposes. These are essential
elements to support the control and eradication of rabies.

To have access to high-quality pharmaceuticals, the availability of rabies vaccines must be

sufficient to eradicate rabies effectively. According to the ASEAN Rabies Elimination
Strategy, the cost and accessibility of human rabies vaccines are constraints to preventing
human deaths. In particular, it is critically important that post-exposure prophylaxis be
much more accessible, especially in remote areas. The rabies vaccine must remain
accessible, particularly in regions with elevated rabies cases. In regions where the disease is
highly prevalent, expanding access to rabies vaccinations can halt the virus's spread and
protect humans as well as animals. So, the availability and accessibility of rabies vaccines are
significant in addressing them effectively.

2.2.2 Lack of access to Public Health and Veterinary Services

Access to public health and veterinary services is very important in creating effective
measures for eradicating rabies. Most deaths from rabies, both in humans and animals, are
due to inadequate access to public health resources and preventative treatment.

Having access to veterinary and public health services is essential for the effective
prevention and control of rabies. These services play a vital role in implementing vaccination
programs, providing post-exposure prophylaxis, conducting surveillance, and raising
awareness. According to the Pan American Health Organization, equitable access to health
services and rabies post-exposure prophylaxis for underserved communities will not only
save lives but also strengthen national health systems. This indicates that enhancing health
services will facilitate the effective implementation of a high-quality healthcare system that
is available to those most at risk of contracting rabies. On the other hand, inadequate health
education initiatives, which are critical to reducing the incidence, will lead to low community
awareness of rabies.

The World Health Organization states that public health services are responsible for
ensuring that individuals have access to affordable or free rabies vaccines. Vaccination

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programs are essential in preventing the spread of the disease among humans. Public health
agencies work to promote and distribute vaccines, particularly in areas with a high risk of
rabies transmission. By providing access to vaccines, they aim to protect individuals from
contracting rabies and reduce the number of human cases.
2.2.3 Lack of education and awareness concerning rabies

Raising public awareness and preventing the transmission of rabies are vital for maintaining
public health. According to the Global Alliance on Rabies Control, raising public awareness
and educating people about rabies is an integral part of rabies elimination. Educating both
the public and professionals by sharing vital rabies information on dog bite prevention, dog
vaccination, and proper treatment and care for bites and other possible rabies exposures
can save lives. Raising awareness about rabies is essential to educating communities about
the risks associated with the disease. Many people are unaware of the severity of rabies and
the importance of taking preventive measures. By providing information about the
transmission, symptoms, and consequences of rabies, individuals can better understand the
need for prevention and seek appropriate care in cases of exposure.

According to the World Health Organization, educating individuals involves working closely
with local leaders, community organizations, and schools to disseminate information and
promote preventive measures. Community events, workshops, and interactive sessions can
be organized to educate individuals of all ages about rabies and its prevention. These
activities can help dispel myths and misconceptions surrounding the disease and encourage
positive behavioral changes.

Collaboration between public health agencies, veterinary services, and local communities is
crucial to implementing effective rabies education and awareness programs. By working
together, these stakeholders can develop targeted strategies that address the specific needs
and challenges of each community. This may include translating educational materials into
local languages, conducting door-to-door awareness campaigns, and providing resources for
vaccination and treatment.

Rabies education and awareness are vital in preventing the spread of this deadly disease. By
raising awareness about the risks of rabies, promoting preventive measures, and engaging

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communities, we can reduce the incidence of rabies and protect public health. Through
collaborative efforts and comprehensive education programs, we can ensure that individuals
have the knowledge and resources to prevent and respond to rabies effectively.

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CHAPTER III
CONCLUSION

Rabies cases pose a threat to humans due to the potential for transmission through bites
and scratches from infected animals. The Philippines has a high number of rabies cases due
to a number of factors, including limited access to quality pharmaceuticals like vaccines and
immunoglobulin, a lack of access to public health and veterinary services, and a general lack
of knowledge about the disease and the significance of getting treatment after dog bites.

The reported number of rabies cases, deaths, and the calculation of the case fatality rate
have reached the highest total number of 254 and incident rate of 0.23 in the year 2022. In
2023, however, the total number of rabies cases and deaths was 230, with an incident rate
of 0.21. This signifies that in the year 2023, the number of rabies cases and deaths will
decrease, thus the calculation of the case fatality rate will also decrease compared to the
previous year.

To control and reduce the number of cases, deaths, and case fatality rate (CFR) in the
Philippines. The following are recommended:

1. Increase the cooperation to eliminate rabies in the poorest of the population that
are most at risk of exposure and death from rabies and maintain rabies-free status in
rabies-free areas in region of the country.
2. By strengthening the capacities of Veterinary Services and Human Health Services to
improve the overall response to rabies, enhance surveillance and control efforts to
eliminate of this deadly disease.
3. Implement comprehensive education and awareness programs about rabies that
support rabies prevention and control.
4. The Governments must ensure a sufficient supply of vaccines for both dogs and
humans, thereby reducing the incidence of rabies and working towards its
elimination.
5. The government, community, civil society and NGOs must collaborate to create a
comprehensive and effective strategy to eliminate rabies.

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REFERENCES

Amoako, Y.A., El-Duah, P., Sylverken, A.A. et al. Rabies is still a fatal but neglected disease:
a case report. J Med Case Reports 15, 575 (2021). https://doi.org/10.1186/s13256-021-
03164-

ASEAN Rabies Elimination Strategy. ISBN 978-602-6392-19-0. https://asean.org/wp-

content/uploads/2017/02/ASEAN-Rabies-Elimination-Strategy.pdf

Department of Health, (2023), “Rabies Cases and Death Reported in 2022 vs 2023 by Region,
Philippines” https://doh.gov.ph/.

Global Alliance for Rabies Control, “Working to Eliminate human deaths from dog Rabies by
2023. https://rabiesalliance.org/toolseducation.

National rabies Prevention and Control Program Strategic Plan 2020-2025. https://rr-
asia.woah.org/wp-content/uploads/2020/03/final-mtp-rabies_philippines.pdf.

Pan American Heath Organization.https://www.paho.org/en/campaigns/world-rabies-day-

2023.

World Health Organization, (2023).

https://www.who.int/news-room/fact-sheets/detail/rabies.

World Health Organization (WHO), Food and Agriculture Organization of the United Nations
(FAO) and World Organization for Animal Health (OIE), 2018 “Zero by 30: the global strategic
plan to end human deaths from dog-mediated rabies by
2030”.https://www.woah.org/fileadmin/Home/eng/MediaCenter/docs/Zeroby30FINALonlin
eversion.pdf.

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